Here is a frightening and sad statistic. During 2016, the United States experienced its largest annual increase in drug overdose deaths, with the total estimated to exceed 64,000. Opioid overdoses largely fueled that increase, and drug overdoses are currently the number one cause of death in Americans under age 50.
The opioid epidemic is hitting particularly hard in middle America, with some counties in Ohio having to request the use of refrigerated trailers to store bodies due to full morgues. In many places in Ohio, heroin overdose deaths have decreased significantly, which sounds like a good thing. The problem is, fentanyl and its analogues are far more likely to be involved in opioid deaths, particularly when sold on the street mixed with heroin.
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Most OD Patients Prescribed Opioids Both Before and After
For every fatal overdose, there are approximately 30 nonfatal overdoses, though the exact number is hard to estimate. Some people may be given Narcan by a friend or family member, with their nonfatal overdoses never accounted for in statistical databases. While it seems reasonable that an opioid overdose would be enough to motivate someone to seek substance abuse treatment, that is not always the case.
In fact, with prescription opioid overdoses, approximately two-thirds of patients filled prescriptions for these medications prior to their overdose. Afterward, nearly 60 percent still had opioid prescriptions filled. Of people overdosing on heroin, 43.2 percent filled opioid prescriptions before their overdose, and nearly 40 percent did afterward. Only one-third of patients surviving heroin overdose and only one-sixth of those surviving prescription opioid overdose received medication-assisted substance abuse treatment after overdosing.
ER-to-Treatment Program Handoff: Ideal, but Rare
Ideally, people who experience opioid or heroin overdose would go directly from the emergency room to a substance abuse treatment facility. However, even in communities that have emphasized this and tried to make it happen, it rarely works out because so many treatment facilities are full. Therefore, after recovering from an overdose, someone with an opioid or heroin addiction may wait weeks for admission to substance abuse treatment. That is often plenty of time for any motivation surrounding the overdose crisis to evaporate and for drug use to resume.
Another issue is state and federal privacy laws, which prevent hospitals from informing outside physicians about overdoses without written permission from patients. In some cases, doctors are not even allowed to notify other departments in their own hospital system without written patient consent.
What Are Some Possible Solutions?
When ER-to-treatment center handoffs can be made, they should be made, because the longer an overdose patient waits for substance abuse treatment, the less likely he or she is to attend and make it work. Some ERs are developing programs where they start their overdose patients on Suboxone (buprenorphine) before they are discharged. The theory is that more overdose patients leaving the ER with a prescription and a plan for obtaining Suboxone will be the catalyst for sticking with medication-assisted treatment, rather than having to wait for admission to a substance abuse treatment facility to start medication-assisted treatment.
Substance Abuse Treatment Choices Are Available
Medication assisted treatment (MAT) is not the only type of substance abuse treatment for people with opioid addiction, but it is believed to be underutilized. Part of this is due to a perception that MAT is just another name for “giving more drugs to drug addicts.” Part of this underutilization is also due to there not being enough trained prescribers, which can lead to improper dosages and ultimately treatment failure. Medicaid and private insurers do not always cover the drugs recommended for MAT either.
This is not to say things are hopeless for people with opioid addiction. Many substance abuse treatment programs are available, and the first step to entering one is reaching out for help to trained counselors who know how to help find the most appropriate treatment program. Opioid addiction is astonishingly powerful, as can be seen from the statistics showing that even an overdose is not always enough to motivate a person to seek treatment.
Fortunately, the right treatment program is even more powerful, helping the person with a substance abuse disorder rebuild and recover, whether MAT or another approach is used. If you struggle with opioid dependency, we encourage you to learn about our treatment program admissions today.